Complete Back-up Federal Write-In Absentee Ballot

The Federal Write-In Absentee Ballot allows voters who have requested their ballot by their state deadline but not received it to vote. Oregon allows you to use this form for registration and voting in general, special, and primary elections for local, state and Federal offices. You may not need to fill out this entire form. Check out the instructions below to see what information your state requires.

Open Back-up Federal Write-In Absentee Ballot

(Opens in a new window and requires Adobe Reader 7)

What do I fill in?

Only the following blocks of the Voter's Declaration/Affirmation are required:

Block 1.a: Select the category that describes you.

Block 1.b: Oregon allows you to use this form for registration.

Block 2.a: Name (Last, First, Middle); Block 2.e: Date of Birth

Blocks 2.f and 2.g: Your valid Oregon Driver's License number or the last four digits of your Social Security number is required for voter registration. If you do not possess either of these identification numbers, the State shall assign a number that will serve to identify you for voter registration purposes.

Block 3.a through 3.e: Complete street address of your Oregon voting residence. A post office box is not sufficient. If your address includes a rural route, describe its location in Block 6. This address must be different from the one provided in Block 4 and must be within the county where you claim legal voting residence.

Block 4.a: Enter your current mailing address. It must be different from the address you provided in Block 3.

Block 5: Enter the name of a political party or write: "not affiliated with a party" if you want to vote in primary elections. If you want to vote in the elections of a political party that has authorized non-affiliated electors, write: "I want to vote in (fill in party) primary."

Block 6: Provide any information that may assist the local election official in accepting this ballot or application.

Block 7: Sign and date. No witness or notary required.

Completing your ballot:

Oregon allows you to use this form for registration and voting in general, special, and primary elections for local, state and Federal offices. For each office for which you vote, write in either a candidate's name or a political party designation.

Once the ballot is complete, fold and place it in the security envelope and seal. Place only the voted ballot in the security envelope and do not write on the security envelope. Insert the sealed security envelope and the Voter's Declaration/Affirmation into the mailing envelope and seal.

Optional: You may print this template on your security envelope

Open Security Envelope Template

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Optional: You may be able to use this postage-paid envelope template

Open Postage-Paid Envelope Template

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The postage-paid envelope may be used in the U.S. postal system which includes: all U.S. Military Post Offices (APO/FPO) overseas or through the diplomatic pouch available at U.S. Embassies/Consulates

Mail

You must mail your back-up Federal Write-In Absentee Ballot to a specific election official. Find your county or city in the address list below to locate your election official.

Open Election Official Address List

Don't know your county? Go to the county finder. Don't know your zip code? Go to the United States Postal Service website.

• Check the "Important Dates" section at the top of this page for deadlines.
• If you receive your state absentee ballot after submitting your Federal Write-In Absentee Ballot, fill it out and return it. The state absentee ballot will be counted instead of the back-up ballot if it's received in time.